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The management of patients with acute ischemic stroke while on direct oral anticoagulants (DOACs): data from an Italian cohort and a proposed algorithm
This study aimed at investigating whether there is any relationship between DOAC plasma levels and the stroke occurrence, on the basis of the phenotypic classification and pathophysiology of the stroke, in a cohort of DOAC-treated patients admitted to our hospital for AIS o ver 1-year period. A total of 28 patients had DOAC plasma levels determined in emergency and were included in the study, nine patients receiving dabigatran, 11 rivaroxaban and 8 apixaban. The DOAC levels were low in 8/28 patients (28.6% of the sample), intermediate in 4 (14.3%) and high in 16 (57.1% ). The most prevalent stroke subtype was the small ves...
Source: Journal of Thrombosis and Thrombolysis - April 16, 2020 Category: Hematology Source Type: research

Reversing the effects of the new anti-clotting drugs
The oral anticoagulant warfarin (Coumadin) became available for prescription in 1954. This anti-clotting drug commanded national attention when President Dwight Eisenhower received the drug as part of his treatment following a heart attack. No other oral anticoagulant was successfully developed and marketed in the United States until 2010. Warfarin is a dangerous drug. Along with insulin, it is responsible for the most emergency hospitalizations due to adverse drug reactions. Whereas insulin causes low blood sugar, warfarin is notorious for the complication of major bleeding. Warfarin is plagued by hundreds of drug-drug an...
Source: New Harvard Health Information - December 9, 2015 Category: Consumer Health News Authors: Samuel Z. Goldhaber, MD Tags: Drugs and Supplements Health Heart Health Hypertension and Stroke anti-clotting coumadin deep-vein-thrombosis DVT Source Type: news

The Role of FEIBA in Reversing Novel Oral Anticoagulants in Intracerebral Hemorrhage
Conclusion In this small case series, reversal of NOAC with FEIBA was not associated with ICH expansion or any thrombotic or hemorrhagic complications.
Source: Neurocritical Care - November 6, 2015 Category: Neurology Source Type: research

A pulmonary vein thrombus in a patient with autonomic nervous dysfunction
Publication date: Available online 8 May 2015 Source:IJC Heart & Vasculature Author(s): Hidekazu Takeuchi Ischemic stroke is a serious clinical problem, and preventing ischemic stroke is an important clinical target. Left atrial thrombus is a known cause of ischemic stroke. In 2015, I reported that nearly all left atrial thrombi result from a pulmonary vein thrombus (PVT), indicating that PVT is associated with ischemic stroke. However, the relationship between PVT and autonomic nervous function is unknown. Although PVT is believed to be rare, since 2012, I have reported several cases of PVT in elderly patients w...
Source: IJC Heart and Vasculature - May 9, 2015 Category: Cardiology Source Type: research

Dabigatran etexilate: management in acute ischemic stroke.
Abstract A 54-year-old man treated with dabigatran experienced new onset of a stroke with a score of 9 on the National Institutes of Health Stroke Scale. Administration of recombinant tissue plasminogen activator (rtPA) was not recommended because of the dabigatran therapy. Angiography showed occlusion of the left middle cerebral artery by an embolic thrombus. Suction thrombectomy achieved flow through the inferior division of the artery. Computed tomography of the head showed possible intracranial hemorrhage, and dabigatran reversal was attempted with prothrombin complex concentrate and recombinant factor VIIa. C...
Source: American Journal of Critical Care - March 1, 2013 Category: Nursing Authors: Javedani PP, Horowitz BZ, Clark WM, Lutsep HL Tags: Am J Crit Care Source Type: research